Aim: This study aimed to compare the efficacy of long-and short-acting gonadotropin-releasing hormone agonist on clinical outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) long protocol cycles. Methods: In this retrospective study, 478 patients were enrolled from October 2012 to November 2014. The pituitary downregulation result, serum hormone levels, gonadotropin (Gn) dose during controlled ovarian hyperstimulation, and outcome of IVF/ICSI-embryo transfer were compared between the two groups. Results: Compared with the long-acting group, in the short-acting group the duration of downregulation and stimulation was significantly shorter; the total Gn doses, cost of an IVF cycle, rate of ovarian hyperstimulation syndrome, superior-quality embryo rate, and implantation rate were significantly lower; and the serum luteinizing hormone concentrations on the day of Gn and human chorionic gonadotropin administration were significantly higher. The serum estradiol level on the day of human chorionic gonadotropin was higher in the long-acting group. However, no significant differences were noted in other parameters. Conclusion: The long-acting group was associated with greater amounts of Gn and a longer duration of use for ovarian stimulation. This increased the cost per IVF cycle and may have had a detrimental effect on the pregnancy outcome because of a subsequent increase in the rate of ovarian hyperstimulation syndrome and decrease in the superior-quality embryo rate and implantation rate.
Sleep-related facio-mandibular myoclonus(SRFMM) is a rare and under-recognized stereotyped parasomnia. SRFMM can present with isolated tongue biting, which can be misdiagnosed as epilepsy and sleep bruxism. We aimed to investigate the clinical characteristics and demographics of patients with SRFMM. Methods: We reported a case of SRFMM and presented a literature review on SRFMM. We searched the Medline, Pubmed, and Web of Science database using the following search algorithm: "facio-mandibular myoclonus" or "masticatory myoclonus" or "tongue biting" limited to publications in English. Results: In total, nine studies were included. In addition to our case, a total of 17 patients were analyzed. SRFMM was found to be more prevalent in males, with a mean age of 48.2 years old. Most of the patients experienced tongue biting during non-rapid eye movement sleep. A majority of the patients were misdiagnosed with epilepsy or sleep bruxism. The simultaneous video EEG and surface EMG was beneficial in confirming the diagnosis of SRFMM. In some patients, clonazepam was reported to ameliorate the tongue biting event.
Conclusion:This study represents a comprehensive summary of SRFMM, which has unique clinical features. Extra-caution may be needed in these cases as it may puzzle neurologists in terms of management.
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